title: Relationship between intravascular ultrasound parameters and fractional flow reserve in intermediate coronary artery stenosis of left anterior descending artery: intravascular ultrasound volumetric analysis.
abstract: OBJECTIVE
  The objective of this study was to assess the relationship between intravascular ultrasound (IVUS) parameters, including volumetric analysis, and fractional flow reserve (FFR).
  
  
  BACKGROUND
  Although it is known that coronary atherosclerosis burden measured by IVUS volumetric analysis is related with clinical outcomes, its relationship with functional significance remains unknown.
  
  
  METHODS
  Both IVUS and FFR were performed in 206 cases of intermediate stenosis of the left anterior descending artery (LAD). Myocardial ischemia was assessed by FFR and maximal hyperemia was induced by continuous intracoronary adenosine infusion. FFR < 0.80 was considered as significant inducible myocardial ischemia. We performed standard IVUS parameter measurements and volumetric analyses. IVUS parameter comparison was performed in the presence (n = 90) or absence (n =116) of significant myocardial ischemia.
  
  
  RESULTS
  Lesions with minimal lumen area (MLA) ≥ 4.0 mm2 had FFR ≥ 0.80 in 91.4% of cases, while 50.9% of lesions with MLA < 4.0 mm2 had FFR < 0.80. The independent predictors of FFR < 0.80 were IVUS lesion length (odds ratio [OR]: 1.1, 95% confidence interval [CI] = 1.06–1.18, P < 0.001) and MLA significance according to the lesion location (OR: 7.01, 95% CI = 3.09–15.92, P = 0.001). FFR correlated with plaque volume (r = −0.345, P < 0.001) and percent atheroma volume (PAV) (r = −0.398, P < 0.001). Lesions with significant ischemia (FFR < 0.80) as compared to those with FFR > 0.80 were associated with larger plaque volume (181.8 ± 82.3 vs. 125.9 ± 77.9 mm3, P < 0.001) and PAV (58.9 ± 5.6 vs. 53.8 ± 7.9%, P < 0.001).
  
  
  CONCLUSIONS
  IVUS parameters representing severity and extent of atheromatous plaque correlated with functional significance in LAD lesions with intermediate stenosis.
authors.forename: Hyoung-Mo
authors.initials: HM
authors.lastname: Yang
authors.forename: Seung-Jea
authors.initials: SJ
authors.lastname: Tahk
authors.forename: Hong-Seok
authors.initials: HS
authors.lastname: Lim
authors.forename: Myeong-Ho
authors.initials: MH
authors.lastname: Yoon
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Choi
authors.forename: Byoung-Joo
authors.initials: BJ
authors.lastname: Choi
authors.forename: Xiong Jie
authors.initials: XJ
authors.lastname: Jin
authors.forename: Gyo-Seung
authors.initials: GS
authors.lastname: Hwang
authors.forename: Jin-Sun
authors.initials: JS
authors.lastname: Park
authors.forename: Joon-Han
authors.initials: JH
authors.lastname: Shin
mesh_terms: D000241:Adenosine; D000368:Aged; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D018084:Ultrasonography, Interventional; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D000241:Adenosine